Table 1.

Session outlines for the treatment groups.

Sessions	Relaxationa		ABCT
1	Visualizations I	Introduction to the different relaxation techniques and learning the distinct types and usefulness of each one of them. Initiation to guided relaxation through visualizations. Imagination of scenes in which one feels at peace and able to let go of stress and anxiety	Preparing compassion	Theoretical aspects of brain evolution, happiness, and suffering. Concept of compassion/self-compassion and elimination of mistaken beliefs. Participants are instructed in mindfulness practices such as breathing, and compassionate body scan. These practices help to regulate attention and emphasize compassionate aspects within oneself. They are a core element of the program
2	Visualizations II	Imagination training. Deepening in guided relaxation through visualizations. Knowing the effects that this type of relaxation has in the body and mind. Learning in which situations it might be useful. Using landscape images to achieve states of relaxation	Self-esteem and compassion	Mindfulness and compassion. Differences with self-esteem. How to manage and cope with fear of compassion. Practices to try to connect with affection and compassion with other beings, and to try to generate feelings of security toward oneself. It is analyzed whether participants have previously developed a mental referent figure in their life, to resort to in distressful situations
3	Visualizations III	Working with emotions through imagination. One visualizes flying in a balloon. Emotional burdens are difficult to alleviate, so they are symbolically released and thrown down, helping the mind to be free of emotions that cause discomfort	Developing my compassionate world	Action mechanism of compassion. Importance of replacing self-criticism with self-compassion. Development of a core element of compassion such as the figure of secure attachment. Replacing the critical voice with a more compassionate and tolerant one. Importance of acceptance in life
4	Autogenic relaxation I	Autogenic relaxation initiation. Knowing the effects this type of relaxation has in the body and mind. Imagining a ball of light and heat to aid sensations of relaxation	Relationships and compassion	Parenting models during childhood. Understanding that relationships with parents generate different ways of relating to the world. Awareness of the emotional bond developed toward parents during childhood, as well as their implications for the emotional functioning of adulthood, and the capacity we have to be able to receive affection from others
5	Autogenic relaxation II	Deepening in autogenic relaxation. Learning in which situations it could be useful and how to use it. Working on heaviness sensations. Body sweeping, especially emphasizing feelings of heaviness and relaxation	Working on ourselves	Reconstruction of a secure attachment model, modifying our relationships with ourselves and with others by compassion. Practices to become aware of our own ability to give affection to others and ourselves. Reconciliation with parents (where appropriate)
6	Progressive relaxation	Initiation to the progressive relaxation. Explanation of this technique and the different benefits of it, such as learning to locate and address bodily tension. Tensing and relaxing the muscles to become aware of the different sensations in both states (i.e., tense vs. relaxed)	Advanced compassion I	Forgiveness and common barriers to compassion. Importance of forgiveness toward oneself and others. Forgiveness through meditation: (1) asking forgiveness of others, (2) forgiving oneself, (3) forgiving others for wrongs received. Values guide activation to reduce suffering
7	Breathing I	Learning to use breathing exercises. Knowing the benefits that this type of relaxation has in the body and mind. Deep inspiration and exhalation. Using breathing to calm anxiety	Advanced compassion II	Envy and the importance of developing an attachment figure based on oneself. How to manage difficult relationships. Trying to understand other’s suffering in order to develop applied compassion in daily life
8	Breathing II	Deepening in breathing exercises and their benefits. Learning different techniques and exercises based on pulmonary or external deep breathing, and on internal or cellular respiration	Transmitting compassion toward others	Equanimity, a quality fruit of compassion practice. How to maintain compassion exercises throughout life. Practices to develop equanimity: we are all the same, the fallacy of categories, giving gratitude. Maintenance of compassion toward others and ourselves

^aRelaxation group.

ABCT, attachment-based compassion therapy.